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Maternal Mortality Review Committee reports decline in pregnancy‑related deaths in 2023; recommends investigating treatment access
Summary
The Maternal Mortality Review Committee presented its 2023 report, reporting 11 pregnancy‑associated deaths reviewed and five determined to be pregnancy‑related; the committee recommended a legislative inquiry into access to care for pregnant and postpartum women.
The Maternal Mortality Review Committee (MMRC), an advisory committee to the Idaho Board of Medicine, presented its 2023 maternal mortality report to the Senate Health and Welfare Committee.
Oren Duffin, program director for the Health Professions Bureau in the Division of Occupational and Professional Licenses and executive officer for the MMRC, told the committee that the MMRC received 13 cases for investigation for calendar year 2023 and that 11 met the committee's criteria for review (death of a woman while pregnant or within one year of pregnancy). Of those 11 pregnancy‑associated deaths, the MMRC determined five were pregnancy‑related and six were pregnancy‑associated but not pregnancy‑related.
Duffin said the committee found a decline in pregnancy‑associated and pregnancy‑related deaths compared with 2021: "Idaho's pregnancy related mortality ratio decreased from 40.1 deaths per 100,000 live births in 2021, down to 22.6, in 2023." Using a more constrained federal methodology (MEC4), Idaho's pregnancy‑related mortality ratio was 13.6 deaths per 100,000 live births, below the federal target of 15.7 per 100,000 for the nation by 2030, Duffin said.
The MMRC identified mental health conditions and hemorrhage as the most common causes of pregnancy‑related deaths in 2023, each accounting for about 40 percent of those deaths. Duffin noted one pregnancy‑related death occurred after the woman did not seek medical care during the prenatal, intrapartum or postpartum period.
The committee reported that medical error or denial of care was not found to be a contributing factor in the reviewed 2023 deaths, and that reviewers did not find direct evidence the deaths were attributable to discrimination in the records examined.
The MMRC made multiple recommendations addressed to different audiences. The single recommendation directed to the Legislature urged investigation of current access to care for pregnant and postpartum women — including those who are incarcerated — with attention to evidence‑based treatments for substance use disorder. Other recommendations included encouraging telehealth to increase access in rural and frontier areas and increasing awareness among providers of treatments for substance use disorder and complications such as sepsis, preeclampsia and hemorrhage.
Committee members asked detailed questions about committee composition, classification of suicides and the circumstances behind specific cases; Duffin said membership and case lists are public in the report and offered to follow up with clinicians on technical questions. The MMRC is scheduled to review calendar year 2022 in 2025 and continues to collect and analyze data for future reports.
